Breaking Down the Member Guidelines: Processing Your Need

At Zion Health, your needs are our priority. Since we put your needs first, we have made processing your needs as simple and efficient as possible. There are no long wait times or messy piles of paper to sort through. Let’s talk about how we process your needs to help you share with Zion Health as easily as possible.

Where do I start?

You can always start by contacting Zion Health! Many times, we can help you find services and discuss whether a specific need would be eligible for sharing. But if you can’t, make your appointment and visit your provider. While you are at the office, make sure to tell them you are a cash pay patient and a member of Zion Health. Then, request itemized bills and receipts for all services.

What documents do I need?

Bring your Zion Health ID card and show it to your provider if the services exceed your IUA. Providers can bill us directly with he information on your card.

When you submit your need request, make sure you have all supporting documents related to your need. For example, include any detailed receipts and itemized bills you have received. You will also need to include a HIPAA release form so Zion Health can request the medical information required to process your need.

Surgery, maternity, and other types of need requests may require additional information. You can see a list of every document you might need on the Need Submission page.

How do I submit my need request?

Though you may mail a paper copy of your need request, we encourage you to submit all need requests online. Using the online need request form is quick and easy. Simply fill in the applicable fields, attach your documents, and write a description of your need in the space provided.

When you describe your need, make sure to include

  • What happened/how you became aware of the need
  • When you first had symptoms
  • Any medication prescribed
  • All dates of service
  • Provider contact information
  • Any expected follow-up appointments

Once your need request is submitted, a Member Needs representative will contact you within a few days to discuss any additional information we might need and help walk you through the process.

Do I pay upfront?

With most providers, you will not have to pay upfront. Providers can work directly with Zion Health to process your bill once you have paid your IUA. If your provider refuses to work with Zion Health, we will work with you and reimburse you directly.

It may be possible to pay your provider before your appointment, depending on the service. You can contact Zion Health to see if your provider visit is eligible for prepayment. We like to prepay for services whenever possible, so please contact Zion Health as soon as possible, especially in non-emergency situations.

How long will it take to process my need?

One of Zion Health’s greatest strengths is how quickly we are able to process needs. By keeping it simple, we can usually process a need within 3-5 business days once we receive all the necessary information. When you contact Zion Health before your service and submit medical documents in a timely matter, it helps us speed up this process even more and make sure your needs are shared right away to keep both you and your provider happy!